The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery

Abstract

Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited.Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire.Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor’s explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time.Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

Letter to Editor Regarding : “The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery”

“…We fully agree with Lee et al 6) for the necessity to discuss the role of telemedicine in neurosurgery and the measures required to ensure its optimal use after the COVID-19 pandemic. Based on our own experience and the literature review, we think some additions would enrich the article by Lee et al 6) .…”

“…We found the article by Lee et al 6) , entitled "The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery" published in your highly valued journal to be really intriguing.…”

“…The increased application of telemedicine worldwide revealed the costs and benefits, as well as some limitations that would hinder the use of this method after the COVID-19 pandemic. To the indicated by Lee et al 6) advantages of telemedicine, we would add both the implementation of quality triage of patients and the rationalization of the preparation for their hospital admission -measures that significantly reduce the costs for the medical facilities 1) . In addition, telemedicine could considerably increase the quality of neurosurgical care by providing the poshttps://doi.org/10.3340/jkns.2023.0116 sibility for consultations with leading neurosurgeons and professional training of young doctors and residents through educational courses online 1,7) .…”

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1)

“…Moreover, many countries are also making changes to their legal systems to accommodate this new paradigm. Recently, several preliminary studies on feasibility of telemedicine have been reported according to this atmosphere [ 29 30 31 ]. The present guideline also tried to explore the potential role and direction that telemedicine may have in the field of neurooncology in the future.…”

Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era

“…COVID-19 pandemic has had an impact in the neurosurgical clinical practice either in changing the way to take care of patients [ 1 , 2 ] or changing the risk of some disease like tumors or brain injuries [ 3 – 6 ]. During recent meetings of the European Society for Pediatric Neurosurgery (ESPN), a certain feeling about a possible change also in the epidemiology of intracranial complications of sinusitis and otitis (ICSO) started circulating based on personal anecdotal reports.…”